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Evaluation of porcine-derived small intestine submucosa as a biodegradable graft for gastrointestinal healing

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Journal of Gastrointestinal Surgery

Abstract

High-risk anastomoses in the gut may benefit from the application of a synthetic reinforcement to pre vent an enteric leak. Recently a porcine-derived small intestine submucosa (SIS) was tested as a bioscaffold in a number of organ systems. The aim of this study was to evaluate the effectiveness of SIS in stimulating healing in the stomach. Twelve rats underwent surgical removal of a full-thickness gastric defect (1 cm) and subsequent repair with a double-layer patch of porcine-derived SIS. The graft was secured with interrupted sutures placed within 1 mm of the edge of the graft. After 21 days, the animals were killed and their stomachs harvested for histologic examination. Cross sections were processed for paraffin embedding and 4-micron sections were stained with hematoxylin and eosin. All animals survived, gained weight, and demonstrated no signs of peritonitis over the 3-week postoperative period. On postmortem examination, the defect was completely closed in all animals by granulation tissue and early fibrosis. Although most of the luminal surface of the grafted areas remained ulcerated, early regeneration of normal gastric mucosa was seen at the periphery of the defect. SIS may act as an effective scaffolding agent for intestinal mucosa and may offer protection in high-risk anastomoses.

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Authors and Affiliations

  1. Departments of Surgery, Duke University Medical Center, Durham, North Carolina

    Sebastian G. de la Fuente M.D., D. Curtis Lawson M.S., Christopher R. Mantyh M.D. & Theodore N. Pappas M.D.

  2. Departments of Pathology, Duke University Medical Center, Durham, North Carolina

    Marcia R. Gottfried M.D.

  3. Durham VA Medical Center, Durham, North Carolina

    Sebastian G. de la Fuente M.D., D. Curtis Lawson M.S., Mary B. Harris R.V.T., Christopher R. Mantyh M.D. & Theodore N. Pappas M.D.

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  1. Sebastian G. de la Fuente M.D.
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  2. Marcia R. Gottfried M.D.
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  3. D. Curtis Lawson M.S.
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  6. Theodore N. Pappas M.D.
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Correspondence to Sebastian G. de la Fuente M.D..

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de la Fuente, S.G., Gottfried, M.R., Lawson, D.C. et al. Evaluation of porcine-derived small intestine submucosa as a biodegradable graft for gastrointestinal healing. J Gastrointest Surg 7, 96–101 (2003). https://doi.org/10.1016/S1091-255X(02)00050-1

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  • DOI: https://doi.org/10.1016/S1091-255X(02)00050-1

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